Presentation
Sudden onset of loss of consciousness
Patient Data
The tip of the basilar artery is markedly hyperdense and there appears to be low density involving the central midbrain and right cerebral peduncle.
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CT angiogram confirms the presence of a filling defect at the tip of the basilar artery. The left superior cerebellar and both posterior cerebral arteries are opacified with contrast. The right superior cerebellar artery is occluded.
Case Discussion
Typical appearances of a basilar tip thromboembolism. Despite endovascular thrombolysis and attempted clot retrieval (which was moderately angiographically effective (not shown)), the patient did not recover consciousness and developed extensive infarction, and eventually passed away.
Note: Top of basilar occlusion is usually embolic, whereas mid-basilar occlusion is usually the result of in situ thrombosis as a result of atherosclerotic plaque complication.
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